“ Knowing your hormonal history increases the chances that the treatment [ your doctors ] choose will be a success .”
This has been the case for Landau , who began working with Dr . Broner five years ago to identify her migraine triggers and create a custom treatment plan , which now includes preventive medication around her period and not combining other migraine triggers during her most vulnerable days .
“ It has changed my life ,” Landau says . “ I still get [ menstrual migraines ], but they are a lot less intense now that I have the right combination of medications .”
Treatment options
Unfortunately , no one treatment method meets the needs of every sufferer or every headache , and the obvious solutions aren ’ t always effective , Dr . Brandes says .
“ The temptation with menstrual migraines is to want to simplify management of the hormonal influence ,” she says .
That might mean going on continuous birth control pills to prevent periods , or using an estrogen patch or other hormone therapies to blunt the hormonal fluctuation .
But such treatments don ’ t work for everyone , according to Dr . Brandes . Many women who are on the pill suffer breakthrough bleeding or continuous bleeding that is triggered by hormone fluctuations , and this can lead to more migraines . Other women are not good candidates for estrogen replacement therapy due to a high risk for cancer or cardiovascular disease .
Instead of assuming a one-size-fits-all approach , doctors must work collaboratively with patients to understand their health risks and headache history . Once this record is established , they can try different combinations of medications and track the results .
“ The often-missed hormonal influence on migraine is why it is so important to keep a headache and menstrual diary and for doctors to take a headache history that includes the hormonal influence ,” Dr . Brandes says .
For women who suffer from menstrual migraines , that history should include when the migraines start in relation to their first period , when during the month the migraines most frequently occur in relation to ovulation and menstruation , and whether the headaches get better or worse as a result of using birth control pills or getting pregnant .
“ If I know that the oral contraceptive pills made your migraines worse in your 20s , I would be more reluctant to prescribe them as a solution in your 40s ,” Dr . Brandes says . “ Knowing your hormonal history increases the chances that the treatment we choose will be a success .” HW
“ Knowing your hormonal history increases the chances that the treatment [ your doctors ] choose will be a success .”
Pop Quiz
How likely are you to get migraines before , during or immediately after your period ?
Somewhat more likely – 1 vote
Less likely – 1 vote
Much more likely – 42 votes
Source : NHF Facebook and online survey
No more likely – 4 votes
I never get menstrual migraines – 2 votes
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